Dermatologic Manifestations of Lymphogranuloma Venereum Treatment & Management
- Author: Jose A Plaza, MD; Chief Editor: Dirk M Elston, MD more...
The treatment of choice for lymphogranuloma venereum (LGV) is doxycycline (100 mg orally bid for 21 d). Although azithromycin is effective against other chlamydial strains and may prove to be effective against infection with LGV serovars, no controlled treatment trials support the use of azithromycin treatment for LGV. Incision and drainage may result in nonhealing fistula formation, which can be minimized by draining involved lymph nodes from above the inguinal ligament. Symptomatic treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and local heat for pain relief may be useful adjuncts.
Immunocompromised persons, such as those with HIV infection, should receive the same treatment as immunocompetent persons; however, given the lack of data, patients with HIV infection and other immunocompromising conditions should be followed closely to assess resolution of symptoms.
Surgery often is necessary for repair of late lymphogranuloma venereum (LGV) complications such as fistulas and strictures.
Surgical consultation for lymphadenopathy is generally not required unless extensive buboes require further exploration. For tertiary disease, appropriate surgical consultation is indicated.
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